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The 4 Treatment Options

So let's talk a little bit about treatment options and ways that you can communicate with your patients, when they show up at your office with signs of instability, tooth wear, mobility, migration, TMJ dysfunction, muscle pain, and soreness.

It's important to organize your thoughts and communications in ways that your patients can very simply understand what you're trying to relate to them.


The 4 R's of Treatment Options

The first of those Rs would be, what if we could just reshape the biting surface with equilibration? The second R would be, what if in addition to reshaping the biting surfaces we need to restore teeth in the process?

You'll discover that in your diagnostic model and your trial equilibrations that sometimes when you reshape, it can be very minimally invasive. Sometimes when you reshape, it's not minimally invasive and we require restorations. So the second R would be restore.

If you can't Reshape or Restore

The third R would be what if you really can’t reshape and restore to get everything in the positions that you need, you have to consider the option of repositioning the teeth. That would be done through orthodontics, either referral to an orthodontist, straight-wire orthodontics, or possibly Invisalign or some of the other products that you can move teeth predictably with.

The fourth option would be, what if you really can’t reposition the teeth without resetting the maxilla, or the mandible, or both? So we think of that as the surgical option with orthognathic surgery. But instead of using that term, you can just talk to the patient about resetting or resecting the maxilla.

And now they’ve got four Rs: restore, reshape, reposition, or reset-- or resect, either one, no problem. But that helps them get their minds around it. It helps you be clear and consistent in your message.

What if they say no?

The final thing I would say if one of your patients says, "I don't want to do any of that," well, then we go into the, "These are the solutions that can really resolve your problem, but if you don't want to do any of that, maybe we can look at some management tools such as splints." So I talk about splints as a way to manage the issue, not solve it. Hope this helps.

To learn more about The Dawson Academy's treatment planning protocols and a pathway to successful and predictable treatment planning, reserve a spot in Functional Occlusion - From TMJ to Smile Design

How to Avoid Mistakes During Dental Treatment Planning

Doyle Freano, Jr., D.M.D. graduated from the University of Kentucky in 1980 with a degree in Biology, and in 1982 received a degree from the University of Kentucky College of Dentistry. From 1987 thru 1994 Dr. Freano was an Associate Professor for Oral Diagnosis and Oral medicine at the University of Kentucky College of Dentistry. Currently he owns a private practice in Lexington, Kentucky, and serves on the Volunteer Faculty at the Lexington Community College Dental Hygiene. Dr. Freano maintains professional memberships in the American Dental Association, Kentucky Dental Association and Bluegrass Dental Association, the American Orthodontic Society, and in 1993, completed an advanced course of study for general dentists with the International Dental Institute in Montreal, Canada for Dentofacial Orthopaedics and Orthodontics for General Practioners.